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August 2016

Volume 2  Issue 4

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Case Report 

A low Anorectal Malformation Exposing a Complete Colorectal Duplication: A Case Report
Aurore Pire AP*,Célia Cretolle CC, Sabine Sarnacki SS , Sylvie Beaudoin SB

Gastrointestinal duplications are rare congenital malformations with an incidence of 1: 4500. Among these, rectocolonic duplications represent only about 12% of the pediatric cases. We herein report a total recto-colonic duplication case diagnosed during a low anorectal malformation surgical repair procedure.

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Case Report 

Large Obstructing Duodenal Diverticulum Mimicking a Cystic Neoplasm of the Pancreas

Jelenc Franc*, MD, PhD, Norčič Gregor, MD

Diverticula can occur anywhere along the small bowel, but are most frequently seen in the duodenum. Diagnosis of this condition is made incidentally in 2% to 6% of upper gastrointestinal contrast studies, in 12% to 27% of endoscopic studies and at autopsy in 22% of cadavers. Most diverticula are asymptomatic and are discovered during evaluation for other gastrointestinal disorders. Perforation and bleeding are the most frequently reported complications. In rare cases, a duodenal diverticulum may become obstructed.

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Case Report 

Embolic Stroke with Visualization of “Paradoxical” Thrombus

Brigid Dwyer*, MD, Jose Romero, MD

In cases of embolic stroke, paradoxical thromboembolic events are a frequent consideration and are thought to represent a significant proportion of strokes in patients under 55, especially those at risk for deep venous thrombosis (DVT). Nevertheless, it is extremely difficult to demonstrate clinically the presumed interatrial transport that underlies this particular stroke mechanism.

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Case Report 

Pulmonary Resection for Primary Lung Cancer in a 97 year-old

Henrietta Wilson*, Michael Ghosh-Dastidar, Karen Harrison-Phipps

Current trends in increased life-expectancy and lung cancer incidence have led to a growing number of elderly patients with nonsmall cell lung cancer. Advances in surgical techniques and perioperative care have led to improved outcomes in octogenarians undergo pulmonary resection. There have been few reports, however, of surgical management in patients over the age of ninety years. Here we report the case of a fit 97-year-old gentleman who underwent thoracotomy and lingular-sparing upper lobectomy for the management of a T2a N0 squamous cell carcinoma.

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Case Report 

Advanced Intrahepatic Cholangiocarcinoma Presenting as a Bilobar Liver Mass

Lienig A., Zoller WG*

In our emergency department, a 70 year old male presented with fever, night sweats and diffuse abdominal pain in the right upper quadrant, which had been ongoing for four weeks. He reported a weight loss of 10kg and a loss of appetite. Until four weeks he felt well. The medical history included coronary  artery disease and diabetes mellitus type 2. There was no family history of malignant diseases. The daily medication consisted of 100mg aspirin.

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Case Report 

The Endoscopic Lateral Approach for the Lumber Spine Hidden Zone in Sciatica Patients: Two Cases

Wataru Shimada, Hiraku Kikuchi* , Yasunori Ito, Sei Mihira, Harutoshi Tsujimoto, Masato Kamiya, Masaki Kawai, Osamu Matsuo

We performed micro-endoscopic discectomy (MED) using the lateral approach on patients with sciatica and achieved good results with high patient satisfaction. Case 1: A 34-year-old man, who was a restaurant manager, had been experiencing back pain for 4 years. Only a nerve root block at L5 was effective in improving his symptoms. Surgery, using an intra-spinal approach at L4/5 and a lateral (extra-foraminal) approach at L5/S1, was employed for the treatment of extra-foraminal disc herniation (EFDH, often called hidden zone herniation). The patient returned to his original work without any complaints. Case 2: A 77-year-old housewife who developed recurrent right sciatic pain.

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Case Report 

Profound Coagulopathy, Lactic Acidosis and Acute Renal Failure in a Diabetic patient taking Dabigatran and Metformin

Vincent J. Colucci*, Pharm D, BCPS (AQ-Cardiology), CPP; Valerie L. Nauditt1; Margaret T. Eddy, MD

A 71-year-old female was admitted for treatment of a left hemispheric stroke secondary to uncontrolled hypertension and carotid artery stenosis. Despite worsening renal function, she initiated on dabigatran 150 mg twice daily. Upon discharge, her home medications, including aspirin and metformin, were restarted. Two weeks after discharge she presented to the Emergency Department lethargic and in moderate respiratory distress. An extensive workup revealed lactic acidosis, acute kidney failure, and profound coagulopathy.

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